According to the latest WHO global estimates, 2.5 billion adults aged 18 years and older were overweight (43%), with nearly 890 million living with obesity (16%). The global age-standardized prevalence of obesity increased from 8.8% in 1990 to 18.5% in 2022 for women and from 4.8% to 14.0% for men (Phelps et al., 2024). In 2022, there were an estimated 44% women and 43% men living with overweight globally (Okunogbe et al., 2022). Women have higher overweight and obesity rates than men, indicating that women face a greater risk and burden of fat-related health problems.

The high prevalence of overweight and obesity among female college students is a significant public health concern that requires immediate attention. A recent study in Ghana by Obirikorang et al. (2024) showed that the prevalence of obesity was higher in female college students (9.4%) than male students (6.7%). The findings further revealed that weight status indicated abnormal central and general adiposity, along with high body fat accumulation, in 17.0% of male students and 33.8% of female students. A review reported that weight gain in young women aged 18–35 years was greater than in older women (Pegington et al., 2020). Several factors contribute to the high rates of overweight and obesity among female college students. Erratic eating patterns, often influenced by demanding academic schedules, can lead to poor dietary choices (Choi, 2020). In addition, high stress levels associated with educational and social pressures can further exacerbate the problem (Jiang et al., 2018). Furthermore, limited access to healthy food options on university campuses can make it difficult for students to maintain a balanced diet. The consequences of overweight and obesity among female college students are far-reaching and potentially life-threatening. These conditions significantly increase the risk of developing a variety of health problems, including metabolic syndrome, adverse cardiovascular events, non-alcoholic fatty liver disease, and cancer, thereby endangering the lives of the population with obesity (Brehm and Steffen, 2013; Faris et al., 2022; Bhattarai et al., 2023).

According to the first law of mechanics and the dietary balance model, the quality and quantity of food consumed directly influence body weight (Walsh, 2013; Carreiro et al., 2016). In college environments, where students often experience newfound independence from parental dietary supervision, there is a greater tendency to consume calorie-dense but nutrient-poor foods (Mancone et al., 2024). This dietary pattern can lead to increased caloric intake, significant weight gain, and altered metabolic pathways, posing significant challenges for weight management (French et al., 2000; Arciero et al., 2013).

On the contrary, being overweight or obese can significantly alter eating behaviors. This change is partly due to hormonal changes that affect physiological hunger cues. For instance, obesity can increase levels of ghrelin (the hunger hormone), leading to increased calorie intake, often from foods that are energy-dense yet nutrient-poor (Cummings et al., 2002; Myers et al., 2010). Furthermore, psychological factors such as stress, which is prevalent among overweight and obese students, often exacerbate unhealthy eating habits (Reichenberger et al., 2021).

Changes in perceived appetite can have a significant impact on an individual's body fat levels. Research has shown that higher perceived feelings of hunger and a stronger desire to eat (DTE) tend to increase overall caloric intake (French et al., 2000; Blundell et al., 2015). When individuals experience heightened hunger and a greater desire to eat, they may consume larger portions or eat more frequently in an attempt to achieve a sense of satiety. However, these altered appetite cues can lead to a higher energy intake than what is actually required by the body. This imbalance between energy intake and expenditure can perpetuate or exacerbate weight gain over time (Bryant et al., 2008; Rosenbaum et al., 2010).

Meanwhile, obesity alters the body's appetite regulation system. Increased body fat can lead to hormonal imbalances, such as leptin resistance; despite high levels of leptin, which should signal satiety, the body continues to feel hungry. This hormonal disruption leads to a decreased sensation of fullness and a continuous DTE (Schwartz et al., 2000; Cummings et al., 2002). According to the satiety cascade theory, perceived appetite includes hunger, satiety, expected food consumption, and DTE (Mela, 2006). However, current research on overweight and obese individuals often focuses on only one or two of these perceived appetite variables (Larsen et al., 2015; Sari et al., 2021; Taş and Gezer, 2022). To gain a comprehensive understanding of the relationship between body composition and appetite regulation in overweight and obese female college students, it is necessary to investigate all perceived appetite variables of the satiety cascade theory in this study.

Furthermore, according to the stress-eating hypothesis, mental health conditions such as depression, anxiety, and stress can also indirectly influence an individual's fat level through their eating behaviors and energy intake (Geiker et al., 2018). Psychological distress often leads to emotional eating, where people use food as a means of self-soothing. This can lead to increased caloric intake, particularly of high-fat and high-sugar comfort foods that are less satiating and nutritionally poor. This type of eating behavior not only contributes to maintaining and exacerbating obesity but also disrupts metabolic responses, making weight management even more challenging (Gibson, 2006; Luppino et al., 2010). By understanding the complex interplay between mental health, eating behavior, and body composition, researchers and healthcare providers can develop more comprehensive and effective interventions to address the multiple needs of overweight and obese female college students.

It is important to note that the relationship between weight status and mental health is bidirectional. Not only can mental health conditions affect eating behavior and body composition, but being overweight or obese can also exacerbate mental health issues (Saghiv and Sagiv, 2020). The stigma associated with excess weight can lead to social isolation, increased stress, and lower self-esteem, all of which can heighten symptoms of depression and anxiety. Moreover, the physiological impacts of obesity, such as hormone imbalances and inflammation, may further contribute to psychological distress. This creates a vicious cycle where mental health problems and obesity perpetuate each other, complicating treatment and intervention strategies (Lloyd-Richardson et al., 2009; Luppino et al., 2010).

Therefore, in order to effectively break these cycles, intervention measures must address both mental health and dietary behavior issues. However, a systematic review by Vajdi and Farhangi (2020) discussed the gaps in research focusing on the interplay between dietary behavior, mental health, and body composition, highlighting that most studies tend to examine these variables in isolation rather than in conjunction. Furthermore, meta-analyses by Psaltopoulou et al. (2013) and Teasdale et al. (2019) noted that while there is a significant body of research examining the interaction between dietary patterns and mental health, the simultaneous assessment of how dietary behaviors and mental health factors affect body composition is still relatively underexplored and needs more comprehensive research. In addition, research in this area has often generalized findings from mixed-gender populations, neglecting the unique physiological and psychological factors that contribute to females (Haynes et al., 2018; Kantowski et al., 2024). Similarly, studies focusing on college students have not adequately addressed the particular challenges faced by this demographic, often grouping them with broader adult populations (Haidar et al., 2018; Lee et al., 2021). Another meta-analysis showed that the rate of energy intake underreporting is about 10% higher in overweight and obese populations compared to the average, indicating a need for more precise studies in this demographic (Teasdale et al., 2019). The findings of this study will serve as a theoretical foundation for the development of multidisciplinary team weight loss intervention strategies that aim to enhance the physical and mental health of female college students in the future.

This finding suggests that energy intake, fat intake, carbohydrate intake, anxiety, and perceived appetite at different timepoints have significant correlations with body composition among overweight and obese female college students. Specifically, high fat intake correlates with increased BMI, body fat percentage, and waist circumference, suggesting that higher intake of fat was associated with increased body composition among those overweight and obese female college students. This is consistent with research by Malik et al. (2006), which analyzed data from young adults and found that saturated fat intake was particularly impactful on body composition. The reason is that high fat intake, particularly saturated fats, leads to increased body fat and abdominal obesity due to higher caloric density and metabolic effects (Malik et al., 2013). Furthermore, the findings indicate a significant positive correlation between energy intake with both body fat percentage and waist circumference, consistent with previous research. Du et al. (2010) found that higher energy consumption was associated with increased body fat and abdominal obesity in a cohort of Europeans aged 20–70 years. Similarly, the significant positive correlation between carbohydrate intake with body fat percentage and waist circumference aligns with Myles (2014), who demonstrated that high carbohydrate diets contribute to greater central fat accumulation in a study of American adults. The reason is that carbohydrates and excess energy intake prefer to accumulate in the abdomen due to higher insulin levels stimulating fat storage in visceral fat cells, which are more metabolically active (McKeown et al., 2002; Després, 2012). These findings indicate that overconsumption of energy-dense foods, particularly those high in fat and carbohydrates, can disrupt the body's energy balance and promote the accumulation of body fat.

This study found an inverse relationship between anxiety levels and body composition. This finding is contrary to the work by Mather et al. (2009) and Luppino et al. (2010), who reported that higher levels of adiposity were linked to higher anxiety among adults in the United States and Brazil individually. The reason for the negative relationship perhaps is that higher adiposity can alter cortisol and serotonin levels, potentially reducing anxiety (Luppino et al., 2010). However, other psychological factors, such as disordered eating behaviors, may play an important role in shaping this relationship. For example, emotional eating and binge eating have been shown to influence body composition, and these behaviors are often associated with heightened anxiety levels (Luppino et al., 2010; Yu and Muehleman, 2023). Therefore, further research on the relationship between body composition and mental health is needed.

The study's findings showed a significant correlation between increased hunger before eating with higher body fat percentage and waist circumference. This aligns with research by Aloufi et al. (2022), which demonstrated that individuals with higher central fat experience greater hunger sensations before meals in a study involving Australian adults. Additionally, there was a significant positive association between BMI and waist circumference with hunger at 60 min after eating in this study. Rolls et al. (2004) found that individuals with a higher BMI are more likely to experience persistent hunger after meals in a study of American adults aged 25–55 years, which can lead to increased waist circumference. In individuals with increased central adiposity, elevated levels of ghrelin, known as the hunger hormone, stimulate appetite, while resistance to leptin reduces the brain's ability to signal fullness, leading to increased hunger sensations before meals (Morris and Rui, 2009; Briggs et al., 2014). Furthermore, higher BMI and central adiposity can disrupt the release of satiety hormones such as glucagon-like peptide-1 and cholecystokinin, resulting in prolonging hunger after meals (Vilsbøll et al., 2003; Strader and Woods, 2005). In addition, inflammation associated with elevated fat levels may further impair these signaling pathways, contributing to increased post-meal hunger (Thaler and Schwartz, 2010).

The findings indicate a significantly positive correlation between BMI with DTE before eating, at 30 min after eating, and at 60 min after eating among overweight and obese female college students. This is consistent with previous research. For instance, Burger et al. (2011) found that individuals with a higher BMI reported a greater desire to eat large portions of food before eating in 130 adults. Additionally, van Galen et al. (2023) demonstrated that a higher BMI exhibited a diminished brain response to nutrient intake, which could explain an increased DTE shortly after meals due to impaired nutrient sensing. The findings indicate that higher body fat percentages are associated with increased DTE both before eating and at 60 min after eating. This aligns with research by Blundell and Finlayson (2004), which found that higher body fat is linked to heightened appetite before eating and increased DTE shortly after meals. However, the correlation between lower DTE at 90 min and higher body fat percentage contrasts with a previous study by Wu et al. (2024), who found that a calorie-restricted diet combined with exercise significantly reduced body fat percentage in young women, along with a reduction in the DTE at later intervals post-meal. This study identifies a significantly positive correlation between waist circumference with DTE before eating and at 60 min after eating. A study by Carnell and Wardle (2008) shows a similar result, which is that waist circumference scores were associated with food cue responsiveness among children. Studies by Obradovic et al. (2021) have shown that higher levels of obesity are associated with elevated levels of leptin, which paradoxically might not effectively suppress appetite in obese individuals due to leptin resistance. However, there is an eventual leptin-mediated response despite initial resistance. This delayed response aligns with findings from Myers et al. (2010), who discussed how leptin signaling defects caused by fat can delay but not completely inhibit satiety signals, leading to a later disappearance of the feeling of DTE post-meal.

The result shows a positive correlation between the sensation of fullness immediately before eating and increased waist circumference. This finding contrasts with one previous study by Heymsfield et al. (2008), which found that a sensation of fullness before eating was negatively correlated with central adiposity. The sensation of fullness 30 min after eating is positively correlated with both body fat percentage and waist circumference, aligning with Liu et al. (2021), who observed prolonged satiety in individuals with higher adiposity due to slower gastric emptying in the postprandially early stage. Higher BMI, body fat percentage, and waist circumference are negatively correlated with fullness at 120 min after eating, which is consistent with findings by Holt et al. (2006) showing a prematurely reduced sense of satiety in obese individuals. Individuals with larger waist circumferences often experience insulin resistance, leading to higher circulating insulin levels, which can initially suppress appetite and create a sensation of fullness before eating (Deusdará et al., 2022). Additionally, individuals with higher central adiposity may have delayed gastric emptying. This delayed process increases postprandial fullness due to prolonged digestion times (Holt et al., 2006; Vijayvargiya et al., 2019). However, leptin and insulin resistance caused by obesity result in reduced efficacy of satiety hormones like peptide YY and cholecystokinin over time, ultimately leading to decreased fullness (Guyenet and Schwartz, 2012; Barakat et al., 2024).

The findings indicate that higher BMI, body fat percentage, and waist circumference are each individually associated with increased PFC before eating. This aligns with previous research by Fisher et al. (2003), which found that individuals with higher adiposity tend to anticipate higher food intake due to altered appetite regulation and energy needs. Additionally, higher BMI is associated with increased PFC at 30, 60, and 120 min after eating, consistent with the findings by Stunkard et al. (2004), who reported that individuals with higher BMI exhibit prolonged anticipatory eating behaviors post-meal. Like the previous reasons for the impact of obesity on hunger, leptin resistance and elevated ghrelin can also reduce the expected appetite before meals (Hernández Morante et al., 2020; Obradovic et al., 2021). Furthermore, higher BMI is associated with lower metabolic efficiency among overweight and obese individuals, which contributes to higher prospective food intake even after eating (Julibert et al., 2019; Johnson et al., 2021).

This cross-sectional study aimed to establish associations, but integrating longitudinal and experimental studies could provide insights into causal relationships and long-term effects. For instance, weight management interventions influence appetite and dietary behaviors (Beaulieu et al., 2021), and longitudinal studies suggest bidirectional links between body weight and mental health (Zhang, 2021). Future research should investigate these causal pathways. Self-reported dietary assessments, commonly used in large cohort studies, are prone to bias but are cost-effective and applicable in large-scale research (Subar et al., 2015; Hébert, 2016). Future studies should employ more accurate techniques like weighed food records or doubly labeled water (Slimani et al., 2015; Ravelli and Schoeller, 2020). Given the impact of physical activity on body composition (Franklin, 2021; Whitfield et al., 2021), future studies should use objective tools like accelerometers to explore the activity-body composition relationship (Bartley et al., 2019). Lastly, as appetite regulation and mental health mechanisms vary with body composition across gender and age, future research should include diverse populations to improve generalizability (van Strien, 2018; Zhao et al., 2020; Diotaiuti et al., 2022; Nour et al., 2024).

The study found significant correlations between nutritional intake, appetite regulation, and mental health with body composition among overweight and obese female college students. Overall, body composition was positively correlated with energy, fat, and carbohydrate intake. In addition, body composition was positively correlated with hunger and PFC at different timepoints, as well as DTE before eating, at 30, and 60 min after eating, but negatively correlated with fullness at 120 min after eating, which is consistent with normal logic. Therefore, if overweight and obese female college students want to reduce their body composition, they need to care about the changes in energy intake, protein intake, fat intake, hunger, PFC, DTE before eating and during the early postprandial period, and fullness during the late postprandial period. However, the study found a negative correlation between body composition with anxiety and DTE at 90 min but a positive correlation with fullness at 0 and 30 min, challenging conventional wisdom. Future research should address these issues, along with limitations related to causal relationships, measurement accuracy, the relationship with physical activity, and population diversity.